Mental health matters

Now that sounds like a spectacular statement of the obvious - and I know that it’s something that everyone here will agree with.

But it’s a principle that, all too often, governments forgot.

For too long, mental health was the Cinderella service - unrecognised and unthanked. And when it came to young people, there was a double injustice, too - as child and adolescent services often received even less attention than adult services in political debate.

Of course, governments can save millions in the criminal justice, education and health systems, when mental health treats conditions early.

But much more important than any fiscal motive, improving mental health is simply the right thing to do.

Take good education - probably the best guarantee of future success.

We know that young people with mental health problems are more likely to struggle at school. If they don’t get the support they need to succeed, we reduce their chances of living and earning well as adults.

NICE guidance suggests almost 60% of looked-after children struggle with emotional and mental health. Ninety-five per cent of imprisoned young offenders have a mental health disorder. More than half of all adults with mental health problems were diagnosed in childhood - and the majority of them didn’t receive appropriate treatment at the time.

In other words, when we’re talking about mental health, so often, we’re talking about young people in the care of the state, or about people who were let down when they were young.

If we don’t have a good mental health system - if we don’t have services that accurately identify who needs treatment, provides it, and then follows it up - then not only are we stunting the ambition of many young people. We are failing some of the most vulnerable people in society.

And that’s simply not acceptable. And this is what drives us: a sense of clarity about who stands to benefit if we get mental health right - or to look at it the other way, will suffer, if we don’t.

It’s why we believe mental health is essential, and that only full equality with physical health will do.

What we’ve done so far

And you can see that principle in our education policies.

Whether it’s funding NSPCC to run ChildLine and HelpLine, for example, or YoungMinds to provide a helpline for parents with mental health difficulties - an essential service, comparable to the contact lines the NHS provides.

Or look at guidance for early years education. The early years foundation stage has 3 main areas: communication development; physical development; and personal, social and emotional development. And all are given equal status.

That’s the approach for school-age education, too. Ofsted have made it clear that they expect schools to look at the ‘whole child’, and will focus inspections on outcomes, rather than meddling in process and telling teachers how to teach. Together with a slimmed down curriculum, this gives schools more freedom to add skill- and character-building activities, promoting the wider wellbeing of children.

And schools now get money targeted at the pupils that need it most.

Poor mental health is often linked to economic deprivation. Not always, but often. So our pupil premium funnels funding to those schools with the poorest children. Lots of schools are using it to buy in extra pastoral support, making learning easier by giving vulnerable children greater emotional and mental stability.

And for children leaving care - who, as we’ve seen, are especially likely to suffer from mental health problems - we top that up with an extra £1000. It’s going by the name of the pupil premium plus, and goes straight to schools.

Schools doing great work

And schools are doing some excellent work in mental health.

Like St Marylebone CE School, just a few miles up the road in the borough of Westminster.

It’s built mental health and wellbeing into its curriculum alongside physical health. Teachers are trained to give practical mental health advice, and pupils get the chance to try activities with benefits for mental and physical health - like yoga, or boxercise.

Or look at Hardenuish School, in Chippenham - which has developed PSHE lessons that tackle difficult issues like self-harm, bereavement or anxiety head-on. Their format allows pupils to air issues in a safe, open environment, and for the school’s pastoral team to help at-risk pupils. Ofsted noted that this means pupils ‘feel safe, and can explain in detail issues around their own safety.’

Or Compton School, in North London. They’ve built strong links with outside services. Barnet council bring 2 mental health projects to visit the school, while Catch 22, the counselling service, provide targeted support for pupils with emotional issues.

That’s just 3 schools. They’re in different parts in the country, with different pupils and different cultures - but they have some things in common.

They’ve made mental health a priority. They’ve all taken the initiative in developing admirable services.

Importance of commissioning

But more than anything - they know their pupils.

It’s sometimes easy, as an adult, to forget just how complex teenage life can be.

Adults have their own worries of course: mortgages, bills, going grey, needing a holiday.

But growing up is a rollercoaster of new experiences and hormones, as everyone tries to work out what they want to do in life - to work out who they are.

These schools get that. You can see it in the services they provide: they are sensitive, targeted, effective. They understand who they’re for.

And this, really, is the heart of the matter.

We use this word, ‘commissioning’, to describe what these schools have done.

Now most teenagers probably wouldn’t hear you out if you started talking about ‘strategic commissioning’ to them - and you could hardly blame them.

But they’re the ones that will suffer if services fail them. If they didn’t join up when needed - if schools don’t talk to hospitals, if local authorities don’t talk to the voluntary sector - it’s young people who will slip through the cracks.

Commissioning is really just a word to express what is actually quite a simple - but a profoundly important idea.

It’s no more - and no less - than making services do the job they’re supposed to do, when they’re needed, where they’re needed.

Good commissioning is the essential task.

And it means 2 of our reforms are particularly important.

Special educational needs reform

First, we’re changing the code of practice for special educational needs which mentions mental health issues for the first time and will help make sure that they are properly identified.

We think a pupil’s behaviour, for example, should be placed in its proper context.

All children go through patches of bad behaviour, and all teachers know that life at home can show up in behaviour or results in the classroom.

Now there are a range of ways to tackle that. It doesn’t help if children who are behaving badly to be automatically treated as having SEN. Indeed, that approach can sometimes prevent schools from recognising underlying issues properly and mean that children don’t get the support they really need. We want to change that.

We care about what young people think about our reforms - they are for them, after all. So please do spread the word among children, just as much as among your colleagues.

Joint commissioning

And the second big reform we’re making is joint commissioning.

This is one of the most important changes in the Children and Families Bill, currently making its way through Parliament - our plan to introduce joint commissioning across health, education and social care.

It’s why we’ve funded BOND, which we’re here to discuss today. Schools have lots of contact time with pupils, but they fit into a wider network of local authorities, charities and other government services.

Improving the capacity of the voluntary and community sector to provide services - and to show they work - is at the heart of BOND.

I want to thank the BOND consortium for all their hard work, particularly YoungMinds for their dedication to the project - and their commitment to getting the best possible results.

The numbers speak for themselves: 88 schools across 5 regions, supporting 95 charities, helping commissioners across 14 local authorities, working with 700 people from 440 organisations.

Those are some pretty impressive stats.

And they represent some extremely impressive stories.

Like the Cambridgeshire BOND pilot. It helped identify gaps in local early intervention services for primary school children - which led directly to a new £98,000 contract to provide those services.

And it spotted a specific in services for children and young people who self-harm. So the voluntary sector has designed a commissioning pathway with the council, specifically for self-harm services.

Self-harm is, for obvious reasons, extremely delicate - one of the most complex issues for teenagers at risk, one of the most heart-breaking and difficult for parents to talk about, and one of the most subtle issues for health and education professionals to handle.

That makes improving services - helping those young people - all the more essential. And that’s exactly what BOND has helped to do in Cambridgeshire.

Or take Tees Valley, which you heard about from Emma this morning.

That pilot brought new money in mental health. Hartlepool council plans to put £50,000 into voluntary sector mental health intervention services in schools. NHS Tees is providing £125,000, and the Clinical Commissioning Group has agreed a further £100,000 to further build the capability of voluntary organisation.

That couldn’t capture the spirit of joint commissioning any better. Local government, schools, the NHS and the voluntary sector all working together and all making mental health a priority. It’s exactly what we want to see.

Looking to the future

As the BOND programme comes to an end, we’ll be reviewing what we can learn from it, and exploring how we can promote its findings - like the ACE-V tool.

Every pilot has something interesting, that can spark ideas and prompt action elsewhere.

Joint commissioning in Teeside, a leadership programme in Liverpool, new service design in Cambridge, resources for teachers in Staffordshire, relations between schools and mental health services in South West London.

Each of these is a rich source of inspiration, beyond the walls of this conference, I hope.

And they come at a good time.

The Children and Families Bill creates a new context - and a new opportunity - for this work. With SEN reform at its heart, the new year will bring a new legal framework for mental health.

And that, really, is just the start.

What all this is about - BOND, our reforms, the whole thing - is making life better for young people. It’s about placing mental health on an equal footing with physical, about every young person getting the same good start in life.

My sense is that there is a growing consensus for the need to tackle this head-on.

That’s what we’re committed to, and what all our policies are designed to achieve.

And I thank you all - and particularly YoungMinds - for your enthusiasm and support in translating it into reality.